Benefits and Risks of Keto: What the Research Shows

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Benefits and Risks of Keto: What the Research Shows

A 2023 big-picture review, published in BMC Medicine and covering 17 meta-analyses of 68 randomized trials, found that keto diets can improve triglycerides, body weight, and blood sugar levels in adults with overweight or obesity – and reduce seizures in patients with epilepsy. 

2025 study also highlights how cutting carbs and entering ketosis can lower body mass index, waist size, and visceral fat – highlighting the power of keto for weight management.

Other research confirms that the keto diet consistently improves markers of metabolic syndrome – a collection of conditions that raise the risk of heart disease, type 2 diabetes, and stroke. It’s also been shown to improve cholesterol levels, reduce inflammation, lower blood pressure, and even slow vascular aging (changes in your blood vessels as you get older). 

Yet for all the benefits, research also highlights serious concerns, including nutrient deficiency, increased heart disease risk, and higher levels of LDL cholesterol (the kind that can build up in arteries and cause heart problems). The BMC Medicine review, too, found a significant increase in LDL cholesterol, underscoring the need for long-term trials to assess keto diets’ impact on the health of the heart and blood vessels.

“The concern is that ketogenic diets are going to raise the level of your cholesterol, and that will be harmful for your heart in the long term, even if there are short-term benefits related to weight loss,” said Sadiya Khan, MD, a professor of cardiovascular epidemiology at Northwestern University Feinberg School of Medicine.

Cutting way back on carbs means you likely have to sacrifice whole grains, fruits, and vegetables, leading to deficiencies in fiber, vitamins, and antioxidants that supplements can’t make up for, said Khan. 

Other long-term adverse effects of keto include digestive issues like constipation, bloating, and diarrhea, and a higher risk of kidney stones.

With that in mind, the safest way to make the most of keto may be to take breaks from time to time. 

A 2024 study found that sticking to a continuous ketogenic diet might age cells – especially in your heart and kidneys – potentially leading to harmful inflammation. But people in the study who took breaks from the diet didn’t have these negative effects. 

“The biggest thing we tried to stress is you don’t want to be on it for too long,” said study author David Gius, MD, PhD, a professor of radiation oncology at University of Texas Health San Antonio. “Take a break. Take a keto vacation.”

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SOURCES:

ScienceDaily: “A long-term ketogenic diet accumulates aged cells in normal tissues, study finds.”

Freedonia Group: “The Rise of Low-Carb, Keto, and Paleo Snack Trends.”

Mordor Intelligence: “Ketogenic Diet Market Size & Share Analysis – Growth Trends & Forecasts (2025-2030).”

Ethan Weiss, MD, preventive cardiologist, University of California, San Francisco.

U.S. Department of Agriculture: “Dietary Guidelines for Americans.”

Frontiers in Nutrition: “A Clinical Perspective of Low Carbohydrate Ketogenic Diets: A Narrative Review.”

BMC Medicine: “Effects of ketogenic diet on health outcomes: an umbrella review of meta-analyses of randomized clinical trials.”

Current Nutrition Reports: “Ketogenic Diet Intervention for Obesity Weight-Loss – A Narrative Review, Challenges, and Open Questions.”

Diabetology: “Beneficial Effects of the Ketogenic Diet in Metabolic Syndrome: A Systematic Review.”

Nutrients: “The Ketogenic Diet and Cardiovascular Diseases.”

Current Problems in Cardiology: “Ketogenic diet and cardiovascular risk – state of the art review.”

Sadiya S. Khan, MD, MSc, Magerstadt professor of cardiovascular epidemiology and preventive cardiologist, Northwestern University Feinberg School of Medicine.

Healthbeat: “Pros and Cons of the Keto Diet: How This Low-Carb Diet Impacts Your Health.”

UChicago Medicine: “Ketogenic diet: What are the risks?”

Science Advances: “Ketogenic diet induces p53-dependent cellular senescence in multiple organs.”

David Gius, MD, PhD, assistant dean of research and professor of radiation oncology, Long School of Medicine, University of Texas Health Science Center at San Antonio; associate cancer center director for translational research, Mays Cancer Center, UT Health San Antonio.

Cleveland Clinic: “Lipid Panel.”

Mayo Clinic: “Blood tests for heart disease.”

Healthline: “A Meal Plan and Beginner’s Guide to the Mediterranean Diet.”

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